Quality of Life After Laparoscopic Sleeve Gastrectomy Usi̇ng Baros System

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) is currently the most frequently performed bariatric procedure in Turkey. The goal of weight reduction surgery is not only to decrease excess weight, but also to improve obesity related comorbidities and quality of life (QoL). Aim: To evaluate the impact of LSG on patient quality of life, weight loss, and comorbidities associated with morbid obesity according to the updated BAROS criteria. Methods: Eleven hundred thirty-eight adult patients were undergone to LSG by our bariatric surgery team between January 2013 and January 2016. A questionnaire (The Bariatric Analysis and Reporting Outcome System - BAROS) was published on social media. The data on postoperative complications were collected from hospital database. Results: Number of respondants was 562 (49.4%). Six of 1138 patients(0.5%) had leakage. All patients who had leakage were respondants. The overall complication rate was 7.7%. After a mean period of 7.4±5.3 months(1-30), mean excess weight loss was 71.3±27.1% (10.2-155.4). The respondants reported 772 comorbidities. Of these, 162 (30%) were improved, and 420 (54.4%) were resolved. The mean scores for QoL were significantly increased after LSG (range, p<0.05 to <0.001). Of the 562 patients, 26 (4.6%) were classified as failures; 86 (15.3%) fair; 196 (34.9%) good; 144 (25.6%) very good, and 110 (19.6%) excellent results according to the updated BAROS scoring system. Conclusion: LSG is a highly effective bariatric procedure in the manner of weight control, improvement in comorbidities and increasing of QoL in short- and mid-term.

Quality of life after laparoscopic sleeve gastrectomy – review of literature

“…D'Hondt et al also presented "good" to "excellent" score in 90,4% of responders at significantly longer time of observation with median of 49 months [27]. On the other hand, "fair" results were observed in 3.9-15.3% of patients in all studies, and failures varied between 0-13% [20,[30][31].…”

“…The very good news is that most recent studies show satisfactory postoperative reflux control in the majority of patients and low rates of de novo GERD after laparoscopic sleeve gastrectomy [37]. Currently there are several modern methods for data collection, follow-up and communication between surgeons and patients such as text messages or social media which could be considered in the holistic approach towards patients with obesity and present-day surgery [20,42].…”

“…Design varied significantly between studies with relatively short follow-up < 12 months in 6 studies and > 12 months in the remaining 7 studies. Majority of the articles (N = 8) included data for small study groups (50-100 patients), 4 studies had 100-200 participants and only 1 analyzed > 500 patients (Tab.1) [20]. Only 7 studies incorporated preoperative analysis of QoL [19,[21][22][23][24][25][26].…”

“…The BAROS questionnaire was used in 5 studies, twice it was paired with the SF-36 [20,26,27,[30][31]. In 2 studies the authors used the updated version of BAROS [14,20,27]. In both versions this questionnaire merges %EWL, improvement of comorbidities, QoL in self-esteem, physical activity, social, labor and sexual aspects, allowing complex assessment of outcomes in bariatric surgery.…”

“…Mean postoperative BA-ROS score was 7.1 (range 4-9) which means that the entire study group (56 patients) achieved an excellent outcome, although no precise information about the distribution of outcomes was included [26]. Slightly less optimistic results are published Kirkil et al in their study on 562 respondents: "good" to "excellent" outcomes in 80% of patients (19.6% "excellent," 25.6% "very good," 34.9% "good") at 7.4±5.3 months of follow up [20]. Bobowicz et al showed that "excellent," "very good" and "good" scores were achieved in 77.5% of patients, at the mean 22 months of follow up.…”